5.1.11 Nitroimidazole derivatives

Alcohol should be avoided during and for 72 hours after tinidazole and at least 48 hours after metronidazole treatment, because of the possibility of a disulfiram-like reaction (flushing, abdominal cramps, vomiting, tachycardia).

Metronidazole

• Tablets 200mg, 400mg (£4.03 = 21 x 200mg tablets, £2.17 = 21 x 400mg tablets)
• Oral suspension 200mg/5ml (£47.38 = 100ml)
• Suppositories 500mg, 1g (£15.18, £23.06 = 10)
• Intravenous infusion 100mg/20ml, 500mg/100ml

Indications

• Acute necrotising ulcerative gingivitis
• Bacterial vaginosis
• Bites (animal and human) - with doxycycline (second line)
• Clostridioides difficile (C. difficile) (first episode, mild cases only - second line)
• Dental abscess
• Eradication of H. pylori
• Giardiasis
• Pelvic inflammatory disease
  • plus ceftriaxone IM and doxycycline or
  • plus doxycycline (second line) (oral regime only)
• Pericoronitis
• Trichomoniasis

Notes

1. Metronidazole oral suspension is not recommended for C. difficile infection (theoretical risk that efficacy of metronidazole benzoate may be compromised because of reduced exposure to gastric enzymes)

Tinidazole

• Tablets 500mg (unlicensed special)

Indications

• Giardiasis

Last updated: 21-12-2021

 

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